What is
it?
Impotence.
The repeated inability to get or keep an erection firm enough
for sexual intercourse. The word "impotence"
may also be used to describe other problems that interfere
with sexual intercourse and reproduction, such as lack of
sexual desire and problems with ejaculation or orgasm.
Impotence
can be a total inability to achieve erection, an inconsistent
ability to do so, or a tendency to sustain only brief erections.
These variations make defining and estimating its incidence
difficult. Estimates range from 15 million to 30 million,
depending on the definition used.
In older
men, it usually has a physical cause, such as disease, injury,
or side effects of drugs. Any disorder that causes injury
to the nerves or impairs blood flow in the penis has the potential
to cause impotence. Incidence increases with age: About 5
percent of 40-year-old men and between 15 and 25 percent of
65-year-old men experience. But it is not an inevitable part
of aging.
Impotence
is treatable at any age, and awareness of this fact has been
growing. More men have been seeking help and returning to
normal sexual activity because of improved, successful treatments
for Erectile Dysfunction. Urologists, who specialize in problems
of the urinary tract, have traditionally treated ED; however,
urologists accounted for only 25 percent of Viagra mentions
in 1999.
What
causes Impotence ?
Since
an erection requires a precise sequence of events, Impotence
can occur when any of the events is disrupted. The sequence
includes nerve impulses in the brain, spinal column, and area
around the penis, and response in muscles, fibrous tissues,
veins, and arteries in and near the corpora cavernosa.
Damage
to nerves, arteries, smooth muscles, and fibrous tissues,
often as a result of disease, is the most common cause of
ED. Diseases--such as diabetes, kidney disease, chronic alcoholism,
multiple sclerosis, atherosclerosis, vascular disease, and
neurologic disease--account for about 70 percent of Erectile
Dysfunction cases. Between 35 and 50 percent of men with diabetes
experience ED.
Also,
surgery (especially radical prostate and bladder surgery for
cancer) can injure nerves and arteries near the penis, causing
Erectile Dysfunction. Injury to the penis, spinal cord, prostate,
bladder, and pelvis can lead to ED by harming nerves, smooth
muscles, arteries, and fibrous tissues of the corpora cavernosa.
In addition,
many common medicines--blood pressure drugs, antihistamines,
antidepressants, tranquilizers, appetite suppressants, and
cimetidine (an ulcer drug)--can produce ED as a side effect.
Experts
believe that psychological factors such as stress, anxiety,
guilt, depression, low self-esteem, and fear of sexual failure
cause 10 to 20 percent of cases. Men with a physical cause
for ED frequently experience the same sort of psychological
reactions (stress, anxiety, guilt, depression).
Other
possible causes are smoking, which affects blood flow in veins
and arteries, and hormonal abnormalities, such as not enough
testosterone.
Drug
Therapy
Drugs
for treating impotence can be taken orally, injected directly
into the penis, or inserted into the urethra at the tip of
the penis. In March 1998, the Food and Drug Administration
(FDA) approved Viagra, the first pill to treat Erectile Dysfunction.
In August 2003, the FDA gave approval to a second oral medicine,
vardenafil hydrochloride (Levitra). Additional oral medicines
are being tested for safety and effectiveness.
Research
on drugs for treating impotence is expanding
rapidly. Patients should ask their doctor about the latest
advances.
The National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
sponsors programs aimed at understanding the causes of erectile
dysfunction / impotence and finding treatments to reverse
its effects. NIDDK's Division of Kidney, Urologic, and Hematologic
Diseases supported the researchers who developed Viagra and
continue to support basic research into the mechanisms of
erection and the diseases that impair normal function at the
cellular and molecular levels, including diabetes and high
blood pressure.
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impotenc, impotnece
| kidney.niddk.nih.gov
| Erectile
Dysfunction |
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